Evidence map›Paper›PMID 15802479›Full record

Trial reportJournal of the American Medical Informatics Association : JAMIA

A randomized trial of electronic clinical reminders to improve quality of care for diabetes and coronary artery disease.

Thomas D Sequist, Tejal K Gandhi, Andrew S Karson, Julie M Fiskio, Donald Bugbee, Michael Sperling, E Francis Cook, E John Orav, David G Fairchild, David W Bates

Registry-linked trialAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00225628 (Improving Quality With Outpatient Decision Support), which is not on this map. Cited by 115 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 20 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00225628 nacompletednot on this map

Improving Quality With Outpatient Decision Support

TypeinterventionalSponsorAgency for Healthcare Research and Quality (AHRQ)Ran2000 to 2006Enrolled3,000ConditionsDiabetes Mellitus, Coronary Artery Disease, Osteoporosis, HypertensionArmsComputerized Reminders Medications Monitoring, Computerized Test Results Management Application, Computerized Reminders Hypertension Management, Computerized Reminders Osteoporosis Screening and Mgt
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 20 syntheses or guidelines pooled it.

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  13. Effect of point-of-care computer reminders on physician behaviour: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2010
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  20. Computerized clinical decision support for prescribing: provision does not guarantee uptake.Journal of the American Medical Informatics Association : JAMIA
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55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Thomas D SequistDivision of General Medicine, Brigham and Women's Hospital, Harvard Medcal School, 1620 Tremont Street, Boston, MA 02120, USA.
Tejal K Gandhi
Andrew S Karson
Julie M Fiskio
Donald Bugbee
Michael Sperling
E Francis Cook
E John Orav
David G Fairchild
David W Bates

Funding

IMPROVING QUALITY WITH OUTPATIENT DECISION SUPPORTU18HS011046 · AHRQ · BRIGHAM AND WOMEN'S HOSPITAL · PI BATES, DAVID W · 2000 to 2002
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AHRQ HHS 5 U18 HS011046
6 · The paper itself

Abstract

objectiveThe aim of this study was to evaluate the impact of an integrated patient-specific electronic clinical reminder system on diabetes and coronary artery disease (CAD) care and to assess physician attitudes toward this reminder system.

designWe enrolled 194 primary care physicians caring for 4549 patients with diabetes and 2199 patients with CAD at 20 ambulatory clinics. Clinics were randomized so that physicians received either evidence-based electronic reminders within their patients' electronic medical record or usual care. There were five reminders for diabetes care and four reminders for CAD care. MEASUREMENTS: The primary outcome was receipt of recommended care for diabetes and CAD. We created a summary outcome to assess the odds of increased compliance with overall diabetes care (based on five measures) and overall CAD care (based on four measures). We surveyed physicians to assess attitudes toward the reminder system.

resultsBaseline adherence rates to all quality measures were low. While electronic reminders increased the odds of recommended diabetes care (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.01-1.67) and CAD (OR 1.25, 95% CI 1.01-1.55), the impact of individual reminders was variable. A total of three of nine reminders effectively increased rates of recommended care for diabetes or CAD. The majority of physicians (76%) thought that reminders improved quality of care.

conclusionAn integrated electronic reminder system resulted in variable improvement in care for diabetes and CAD. These improvements were often limited and quality gaps persist.

Indexed as

Attitude of Health PersonnelGuideline AdherenceMedical Records Systems, ComputerizedQuality of Health CareReminder SystemsAlgorithmsAttitude to ComputersCoronary Artery DiseaseDiabetes MellitusHumansPhysicians, FamilyPractice Guidelines as TopicRegression AnalysisSurveys and Questionnaires

Identifiers

PMID15802479
PMCPMC1174888

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.